Individual provider Active NPI

Kikelomo Beatrice Adenekan, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
National Provider Identifier
1730055120
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1069927 Issued in TX
Practice address
2021 Guadalupe St # 260
Austin, TX 78705-5654
Phone
(214) 686-7909
Fax
(419) 452-4265
NPI assigned
Oct 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 1069927 TX Primary

Addresses

Primary practice location

2021 Guadalupe St # 260
Austin, TX 78705-5654

Mailing address

2021 Guadalupe St # 260
Austin, TX 78705-5654
Phone (315) 876-0103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1069927TXMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1730055120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 GUADALUPE ST # 260",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787055654",
            "telephone_number": "315-876-0103",
            "fax_number": "419-452-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 GUADALUPE ST # 260",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787055654",
            "telephone_number": "214-686-7909",
            "fax_number": "419-452-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADENEKAN",
        "first_name": "KIKELOMO",
        "middle_name": "BEATRICE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1069927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.